APA Wins Government Grant to Develop Quality Measures for Behavioral Health

Under a cooperative agreement with the Centers for Medicare and Medicaid Services (CMS), APA was awarded $5.38 million over three years to develop meaningful quality measures for behavioral health under the Medicare Access CHIP Reauthorization Act of 2015 (MACRA). These measures are intended for use by a wide range of health care providers, including psychiatrists, social workers, and other behavioral health providers, as well as primary care providers.

The quality measures will focus on measurement-based care, evidence-based care, and care experience. Major diagnostic categories include opioid use disorder, first-episode psychosis, and suicidality, but they do not exclude other psychiatric conditions.

The measures developed under APA’s Quality Measure Development Initiative will fill CMS’s designated priority gap areas of mental and substance use disorders. In collaboration with the National Committee on Quality Assurance, the initiative places quality measure development in the hands of psychiatrists, other health providers, and stakeholders and will focus on improvements in quality care and burden minimization for individuals with mental and substance use disorders and providers alike.

The initiative will “engage consumers, technical experts, and a Learning Collaborative of 20 to 25 diverse behavioral health practice sites, involving 400 clinicians,” according to Philip Wang, M.D., Dr.P.H., APA’s director of the Division of Research. Learning Collaborative sites will be recruited from practices that are members of APA’s national mental health registry, PsychPRO. Data from participating sites will inform various aspects of the initiative.

“Each proposed quality measure will undergo rigorous development, employing established methods for measure specification,” noted Wang.

APA members Jerry Halverson, M.D., and Anna Ratzliff, M.D., Ph.D., will co-chair the initiative’s multi-stakeholder Technical Expert Panel. The panelists, composed of behavioral health care experts, were selected at the close of a 30-day nomination period and represent the various perspectives of those involved in the care of individuals with mental and substance use disorders. This includes individuals and family members of those with mental and substance use disorders, behavioral health providers, facility administrators, health plan leaders, researchers, and other advocates.

Halverson and Ratzliff, both experienced in the development and use of quality measures, spoke with Psychiatric News about their involvement in this national quality enterprise. Halverson has been highly engaged in producing and using quality measures for psychiatric treatment following his completion of intensive training at the Intermountain Healthcare Delivery Institute.

Since then, Halverson explained, “Much of my work has been through my employer, Rogers Behavioral Health (a national, private, not-for-profit behavioral health system), and other national organizations like APA, the AMA, and PCPI [formerly the Physician Consortium on Performance Improvement]. I was also on the Technical Expert Panel for CMS’s Measure Development Plan.”

Ratzliff described her psychiatric and academic career as one spent “delivering and implementing the Collaborative Care Model.” One of the core principles of this behavioral health integrated care model is accountability for the quality of mental health care delivered by a team imbedded in a medical setting. “This work has allowed me to explore patient and provider experiences, [clinical] processes, and outcome measures of quality in a wide variety of settings,” she said.

Most recently, Ratzliff served as a national faculty member for APA’s Transforming Clinical Practice Initiative and noted that she “had the opportunity to support transition of practice to value-based contracting.”

Under Halverson and Ratzliff, APA’s Technical Expert Panel will be prepared to inform on the development of behavioral health quality measures that influence high-quality, patient-centered care for use in value-based payment programs.

As Ratzliff explained, “Measuring health care quality is important for multiple reasons, including informing on gaps and variation in care delivery. These findings tell us how the health system is performing and will ultimately lead to the opportunity to improve care.”

Clinicians who treat patients in the various outpatient settings for mental and substance use disorders and who join the Learning Collaborative will have a valuable opportunity to advise the Technical Expert Panel and Consumer and Family Panel on the utility of these new measures. The feedback loop between the panels and Learning Collaborative participants ensures that the quality measures developed under the initiative will be meaningful to patients and can help health care professionals improve the care they provide. ■